European Drug Report 2017: Trends and Developments. In Europe, problems related to highly potent synthetic opioids appear to be growing, as indicated by increasing reports of non-fatal intoxications and deaths received by the Early Warning System. In early 2017, the EMCDDA carried out risk-assessment exercises on the fentanyl derivatives acryloylfentanyl and furanylfentanyl.
Drug Trend Reports Express Scripts Canada’s drug-trend analysis provides comprehensive research on the use of prescription medications in the Canadian private sector. • (10 MB pdf) • (8 MB pdf) Downloadable PDF Versions: • (12.5 MB pdf) • • • • • A password is required to view material published between 2011-2015. If you are an Express Scripts Canada client or a selected broker/consultant partner, please send us an to obtain your password.
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In 2017, CVS Health pharmacy benefit management (PBM) strategies reduced drug trend for commercial clients to the lowest level in five years, 1.9 percent per member per year (PMPY), keeping drug price growth at a minimal 0.2 percent despite manufacturer price increases of almost 10 percent. Forty-two percent of our payor clients spent less on their pharmacy benefit plan in 2017 than they had in 2016.
We also helped members save money and lower out-of-pocket (OOP) costs. Nearly nine out of 10 members spent less than $300 OOP in 2017, and monthly cost per member declined by 10 cents to $11.89. To further enhance affordability and price transparency, we introduced real-time benefits enabling prescribers to see the member-specific OOP costs of a prescribed medication as well as the costs of clinically appropriate alternatives in real-time.
This allows them to offer members medication options that may be more affordable. Keeping drugs affordable helped improve adherence. We increased the number of optimally adherent members in key categories like diabetes, hypertension and hyperlipidemia by as much as 1.8 percentage points. In 2018, we are doing even more to help keep drugs affordable with our new Saving Patients Money initiative.
Saving Patients Money is designed to help address the high cost of prescription drugs by providing greater pricing transparency across all points of care, including at the pharmacy, and directly to members. At CVS Health, we share a clear purpose: helping people on their path to better health. Through our health services, plans and community pharmacists, we’re pioneering a bold new approach to total health.
Making quality care more affordable, accessible, simple and seamless, to not only help people get well, but help them stay well in body, mind and spirit.
Between its annually published Drug Trends report, and the press release announcing it, Express Scripts makes a strident case for employers and other health plans to use its techniques to constrain drug costs.
Overall, the company says its health-plan customers saw a cost increase of only 3.8% in calendar year 2016, and unit costs increased even less (2.5%). (The difference between the two is mostly from whatever change has occurred in prescription usage by covered patients.) Express Scripts compares these percentages to generally higher measures of price inflation, of either brand drugs or prescription drugs overall; for example, its Price Inflation Index, which measures list-price increases, was up 11% for branded drugs in 2016.
(Generics, which are by far the greater portion of drug dispensing, saw their list price drop in the same index by 8.7%.) Part of the stridency might be coming from PBMs like Express Scripts being blamed for the higher margins between pharma manufacturers’ net revenue and the list prices of their drugs (with PBMs soaking up a portion of that margin in their own profits); but another part is that Express Scripts’ techniques are successful: when some higher-cost but equivalent-therapy drugs are on exclusion lists, and when healthcare providers (HCPs) are constrained by which drugs they and prescribe to their patients, a counterpressure is exerted on drug costs.
Express Scripts’ biggest effort, arguably, is in winning those rebates from manufacturers, who are competing to get on formulary, or have a preferential formulary position. “Rebates do not raise drug prices, drug makers do,” said Dr. Glen Stettin, MD, Chief Innovation Officer, who uses some circular logic to assert that “As demonstrated by lower overall and unit cost trend in 2016, Express Scripts is effective in protecting employers from the effects of inflation by using our focused size and scale to secure significant rebates, which are returned to employers to reduce the overall cost of their pharmacy benefit.” Express Scripts also touts its success in specialty pharmaceutical cost control; the cost increase experienced in here in 2016 was 13.3%, “the lowest trend reported since [Express Scripts] first included specialty medications in our annual analysis in 2003,” but significantly, specialty drugs accounted for more than a third of total spending in 2016.
The company established what it calls the SafeGuardRx program, which puts specific requirements on drug dispensing for a variety of therapeutic classes, that help control specialty costs.
Under its National Preferred Formulary plan, Express Scripts excludes some 80 drugs from formulary, based on the availability of alternative choices, or for questions on the therapeutic value of the drug; this program saved Express Scripts clients $1.3 billion in 2016, and is projected to save $1.8 billion in 2017.
Finally, the company says that it has eliminated 95% of spending for “unnecessary and potentially unsafe” use of compounded medications; over the past two years this saved $2 billion.
The full report is accessible .